The present invention is related to an improved method and apparatus by which patient information is entered, accessed and processed.
The invention relates to a method and apparatus for the storage of encrypted or otherwise similarly stored data. More particularly a method for recording personal, insurance and other information on a card or card-like medium. In turn, said information is or can be recorded and "read" from an area contained on said card that may or may not be visible to the naked eye and may or may not be readable by the naked eye. Said visible area is capable of containing a laser readable, magnetic strip or strips or other like means of information storage, for future dissemination.
Data management in the fields of medical, dental, ophthalmological, podiatric, chiropractic, pharmacological and other health care areas as well as in many professional fields has become a pervasive complex, financially expensive and time-consuming aspect in the provision of health care or respective services. The respective professionals must divert valuable time, energy and resources to address the ever expanding sea of paperwork and the complicated field of data management. Accordingly, service and care providers are unable to direct or focus a majority of their time to the provision of care and services that they otherwise would and the cost of providing patient care has increased while reimbursement has decreased. Insurance companies have gained an ever increasing presence in every imaginable field of health care as well as service industries, providing for the vast majority fee payments. For fee payment a literal plethora of forms, requests and releases must be filled out--for every individual patient--in order for the care or service provider to be paid, reimbursed or otherwise compensated for the services or care rendered.
For example, when a patient sees a new doctor or seeks treatment in a clinic or hospital for the first time, and in many instances every time thereafter, it takes the service or care provider, or their respective staff, between fifteen (15) minutes to one (1) hour--or more--to fill out all the forms, questionnaires, check the applicable sources and facts, check the information's accuracy and the completeness of all the above mentioned details. Additionally, for many reasons, it is often necessary to check with the insurance company, previous service providers, clinics and hospitals to insure the completeness, accuracy and veracity of the information provided. In many instances, the information as well as any supplemental material, must be gained and/or verified without the patient's/insured's help, and is therefore difficult to obtain quickly. Generally, the only readily verifiable identification that a patient's carries is a drivers license. The large number of managed care companies with all of their rules and programs have confused the patient and confounded the provider.
Identification issues aside, managed care, private insurance, business insurance plans and government sponsored health care generally account, or accounts in relative proportions, for payment of the vast majority of patient fees of those seen by a health care provider. Billing procedures and management are generally computer generated and managed in virtually all active practices, laboratories, emergency rooms, hospitals and clinics. Most major insurance carriers, as well as state health care programs and Medicare, encourage and/or only accepts electronically filed claims. Electronically filed claims expedite the processing and satisfaction of many claims submitted. Additionally, electronically filed claims vastly reduce the amount of unnecessary paper that would otherwise be required. In further evidence of the above, Medicare only accepts electronic claim. Medicare is presently accepted by 90% of physicians and essentially all hospitals, clinics and labs. Furthermore, due to the progressive aging of our society such electronic claims will rise out of necessity. A problem with the filing, processing and satisfaction of any electronically filed claim is that all the information must be absolutely correct and the format must be in full compliance with the requirements of the insurer.
At present, in a vast majority of the offices, patients complete questions on handwritten forms. A receptionist, who is usually not trained at or in data entry, must enter this patient and insurance information into the computer while concurrently accomplishing and performing many other tasks, duties and responsibilities. Not only is this inefficient, errors in data translation and entrance occur quite frequently, resulting from patient and/or provider employee error and/or omission. In the event procedures (i.e., and not limited hereto, biopsies, consults, blood specimens, culture trays) are performed or ordered, a patient's information and insurance's data must be again transcribed, providing another opportunity for error. Such errors may result in the insurance carrier's outright refusal or significant delay in payment for the care or service provided. All errors and/or omissions must be corrected before the insurance claim is paid--if at all. Such corrections requiring meticulous and time consuming review and additional phone calls that result in further delay in the providing services and claim payment--if payment is remitted at all. The whole process is very burdensome, time-consuming, costly, and aggravating for the patient, respective professional offices and insurance carrier. To address and partially remedy the aforesaid problems, while nevertheless giving rise to new ones, additional employees must be hired in a stop gap attempt to cope with errors, call insurance companies, review the patient's files and review all the aforementioned work to check and verify its veracity. In turn, the additional employees, paperwork and support mechanisms tend to interfere with the normal flow of patients, and subsequent rendering of care. Furthermore, many people have substantial difficulty filling out the long forms whereas others simply refuse to fill out the forms. These problems are ever compounding and increase in magnitude as the United States population ages. Furthermore, patients with language barriers, mental handicaps, the acutely ill and unconscious patients are partially and/or totally unable to complete any of the required forms for authorization of payment and more specifically and importantly treatment.
Other complicating aspects of managed care, or similar provided services, lie in the fact that each particular payment provider often has several programs with different requirements, restrictions, codes, forms and even several different billing addresses. As a result of all the above-mentioned problems another problem arises in the reluctance of medical care providers to comply with any additional record keeping and reporting requirements, especially in the midst of busy patient care. In addition, there are significant burdens associated with the time, cost and amount of paperwork required for proper patient processing that causes many physicians and institutions to reject particular insurance plans and carriers. This is socially troublesome as it effects the income of our physicians and hospitals and breaks the long standing doctor-patient relationships.
A need has clearly arisen whereby the care provider would have a method and device to assure accurate and complete demographic and insurance information on the patient, that may also include basic "medical-alert" information. The present disclosure addresses such needs.
A review of the present field of devices and methods that attempt to address some of the aforementioned problems, individually or in combination, evidences no such device as disclosed herein.
For instance medallions and bracelets have been worn by some persons suffering from particular conditions such as diabetes, hemophilia and antibiotic allergies. These provide very limited capability for information storage and dissemination and are often not worn. Thus, a need exists to provide a means for more adequately and thoroughly describing a person's medical history on a device which can be easily carried by all individuals. Furthermore, these devices fail to address the burdens associated with the insurance companies.
Relating to hospital or patient care environments, a label printer which makes self-adhesive labels from an identification plate attached to a patient wristband is described in promotional literature from Bio-Logics Products, Inc., Salt Lake City, Utah and in U.S. Pat. No. 4,145,966.
In U.S. Pat. No. 4,692,394, Drexler discloses a personal identification card on which there are recorded visual images, such as a face image or fingerprint, and laser recorded data. By means of in situ laser recording, transaction data, information, or the like related to the photographic image is recorded at subsequent times. For example, insurance claims or medical record entries may be processed sequentially. A photograph of the claimant is alleged to protect against fraudulent use of the card.
Miller, et al., U.S. Pat. No. 3,694,240, and Estrada, U.S. Pat. No. 4,325,570, disclose an identification systems in which an individual's fingerprint is taken at the time identification is to be made and compared to a fingerprint record in a master file of the person the individual purports to be. These disclosures are both time consuming and require the recording and maintenance of additional fingerprint files for verification.
In U.S. Pat. No. 4,730,849, Siegel discloses a device and system for the identification of medication in an attempt to assure that only the patient for whom the medication was prescribed will receive it. A photograph of the patient is affixed to the medication container, in the form of a label, and/or patient record, such as a medication card or chart. Alternatively, upon admission a patient may be issued a "non-removable" identifying wrist band having a machine-readable portion and, optionally, a computer-generated likeness or a photograph of the patient. Before treatment, the coded information on the patient wristband can be compared with that introduced into computerized central records upon admission.
In U.S. Pat. No. 4,236,332, Domo discloses a medical record card containing a microfilm portion having some data visible to the eye and other data visible by magnification. The directly visible data is alphanumeric character codes pertaining to emergency medical conditions of the patient and the magnified data portions detail the medical history.
In U.S. Pat. No. 4,213,038, Silverman et al., teaches an access control system with an identification card. The card has machine recordable indicia used to choose a master microspot pattern from the machine's memory. This master pattern is compared with an identical pattern on the card for verification. The card also has space for a picture and a signature. Similarly, in U.S. Pat. No. 4,151,667, Idelson et al., teaches an identification card having a photograph and a phosphorescent bar code pattern used for verification. The amount of information these cards can hold is extremely limited. Random microspot patterns can only be used for verification, while one dimensional bar codes can only represent a small amount of specific data.
Yet in other prior devices, systems have been proposed which include one (1) or more magnetic and manual entry data entry terminals at the health care provider facilities, various verification and authentication routines, data storage which includes lists of insurance companies or other payers together with lists of medical procedures for which such payers are obligated to make payments, schedules of permissible fees for such procedures and selected data related specifically to each covered patient. None of which claim reference to insurance forms and the errors associated therewith.
Such systems have, thus far, not featured a total health care approach nor delivery means, thus failing to adequately address the problems inherent with insurance. Nor, have such systems integrated the important elements of total health care system as contemplated by a total health management system. Since these missing functions, i.e. insurance processing, are important ingredients to a comprehensive medical care or insurance program, a need has arisen for a system that provides a full or more thorough integration of insurance processing.
In sum, none of the prior devices disclose a device that adequately displays the important insurance or medical history of an individual in a manner that may be easily read and used. Furthermore, none of the prior systems are sufficiently adaptable to inexpensive production. No reliable method for direct and accurate, insurance information has been achieved.